scholarly journals Infertility and subsequent recurrent miscarriage: Current state of the literature and future considerations for practice and research

2021 ◽  
Vol 4 ◽  
pp. 100
Author(s):  
Laura Linehan ◽  
Marita Hennessy ◽  
Keelin O'Donoghue
Keyword(s):  
Qualitative Research ◽  
Pregnancy Outcomes ◽  
Recurrent Miscarriage ◽  
Management Strategies ◽  
Psychological Needs ◽  
Controlled Vocabulary ◽  
Care Needs ◽  
Clinical Guidance ◽  
Adverse Pregnancy ◽  
Specific Care

Background: Recurrent miscarriage (RM) and infertility are independently associated with adverse pregnancy outcomes, in addition to psychological sequelae. Experiencing pregnancy loss alongside infertility is particularly difficult. International guidance regarding RM is conflicting, and applicability to women with infertility is undetermined. The aim of this study was to: (i) establish if women/couples with a history of infertility are recognised in the literature on the investigation and management of RM, and (ii) determine if the specific needs of women/couples experiencing RM and infertility are ascertained and incorporated into clinical management strategies. Methods: We examined the wide-ranging literature to ascertain what gaps existed. Studies were retrieved through searches of PubMed and Google Scholar up to 21 January 2021 using appropriate controlled vocabulary and combinations of key words. No language or study design restrictions were applied. Results: While women/couples experiencing RM after infertility appear in studies evaluating investigations and proposed treatments, high-quality studies are lacking. Furthermore, they are largely excluded from international clinical guidance and qualitative research. Conclusions: The experiences of women/couples with RM and infertility and their specific care needs within maternity and fertility services are underexplored. It is unclear from current RM guidelines how best to manage and support this complex cohort. Women/couples with infertility and RM are underserved in the literature and in clinical guidance. Further robust studies are warranted to examine pregnancy outcomes, investigations and treatments currently used. Qualitative research is also required to identify their medical and psychological needs to better support this vulnerable group.

scholarly journals Protein Z, an anticoagulant protein with expanding role in reproductive biology

Reproduction ◽  
2013 ◽  
Vol 146 (2) ◽  
pp. R73-R80 ◽  
Author(s):  
Wassim Y Almawi ◽  
Fatima S Al-Shaikh ◽  
Ohannes K Melemedjian ◽  
Ahmad W Almawi
Keyword(s):  
Vitamin K ◽  
Pregnancy Outcomes ◽  
Recurrent Miscarriage ◽  
Factor Xa ◽  
Protein S ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Protein Z ◽  
Venous Thromboembolic ◽  
Adverse Pregnancy

Protein Z (PZ) is a vitamin K-dependent factor characterized by its homology to other vitamin K-dependent factors (factors VII, IX, and X, protein C and protein S), but lacks any enzymatic activity. Instead, PZ acts as a cofactor for the inhibition of factor Xa through the serpin PZ-dependent protease inhibitor (ZPI). PZ deficiency is associated with a procoagulant state, highlighted by excessive FXa secretion and thrombin production, and is linked with several thrombotic disorders, including arterial vascular and venous thromboembolic diseases. A role for the PZ–ZPI complex in the regulation of physiological pregnancy has been demonstrated, highlighted by the progressive elevation in PZ levels in the first trimester of gestation, which then steadily decline toward delivery. An association between altered plasma PZ concentrations and adverse pregnancy outcomes (recurrent miscarriage, stillbirth, preeclampsia, intrauterine growth restriction, and placental abruption) has been reported. The mechanism by which PZ deficiency leads to adverse pregnancy outcomes is not clear, but it is multifactorial. It may be attributed to the anti-PZ IgG and IgM autoantibodies, which apparently act independently of classical antiphospholipid antibodies (lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein I antibodies). PZ deficiency has also been reported to be constitutional, and a number of variants in thePROZ(PZ) gene andSERPINA10(ZPI) gene are linked with specific adverse pregnancy complications. This review summarizes the relationship between adverse pregnancy outcomes and acquired and constitutional PZ–ZPI deficiency, in order to understand whether or not PZ deficiency could be considered as a risk factor for poor pregnancy outcomes.

Reproductive health issues in patients with psoriasis (literature review)

2019 ◽  
Vol 1 (7) ◽  
pp. 5-8
Author(s):  
L. S. Kruglova ◽  
A. A. Osina ◽  
A. A. Khotko
Keyword(s):  
Drug Therapy ◽  
Reproductive Health ◽  
Literature Review ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Certolizumab Pegol ◽  
Genetically Engineered ◽  
Health Issues ◽  
Degree Of Confidence ◽  
Adverse Pregnancy

Among patients with psoriasis, approximately 50% are women and almost 75 % of them are under the age of 40 years. Thus, most women with psoriasis have childbearing potential. When pregnancy occurs in 22 % of patients, the activity of psoriasis persists, characteristic of the course before pregnancy, in 23 % of women, the course of the disease worsens. The article provides up-to-date data on the management of pregnant patients with psoriasis. To improve pregnancy outcomes in patients with psoriasis, it is important to prevent exacerbation of the disease. The choice of drug therapy in this case is based on an assessment of the ratio of the risk of undesirable effects of the drugs on the developing fetus and the risk of the development of exacerbation of psoriasis, which can cause an adverse pregnancy outcome. Despite the fact that the available clinical experience of using genetically engineered drugs is still limited, with a certain degree of confidence we can say that there is no increase in the risk of adverse pregnancy outcomes associated with therapy with certolizumab pegol.

The prevalence of Trichomonas vaginalis and Candida albicans infection in the lower genital tracts of antenatal patients in Abakaliki, Southeastern Nigeria

1970 ◽  
Vol 4 (1) ◽  
pp. 11-14 ◽  
Author(s):  
IM Sunday-Adeoye ◽  
JOK Adeoye ◽  
OUJ Umeora ◽  
PI Okonta
Keyword(s):  
Candida Albicans ◽  
Pregnancy Outcomes ◽  
Trichomonas Vaginalis ◽  
Dropout Rate ◽  
Antenatal Clinic ◽  
Southeastern Nigeria ◽  
High Dropout Rate ◽  
Adverse Pregnancy ◽  
June July ◽  
A Prospective Study

Aims: To determine the prevalence of Trichomonas vaginalis and Candida albican infection among anasymptomatic pregnant population and to document their pregnancy outcomes.Methods: This was a prospective study involving antenatal clinic attendees at the Ebonyi State UniversityTeaching Hospital, Abakaliki, Nigeria. They were randomly recruited and informed consent obtained. Vaginalspecimens were collected from them and analyzed in the laboratory. They were followed up till delivery andpregnancy outcomes documented.Results: Two hundred expectant mothers were recruited. The prevalence rate of Trichomonas vaginalis andCandida albicans were 0.5% and 27.5% respectively. Due to the high dropout rate in the study, it wasimpossible to make any reasonable inference about the pregnancy outcomes associated with these conditions.Conclusion: There is probably the need for the use of more sophisticated methods for the detection ofTrichomonas vaginalis. The existing methods in most laboratories in the country may not be adequate. Thereis also probably the need for a larger sample size and a stricter follow up of the patients in order to documentany adverse pregnancy outcomes associated with these conditions.Keywords: Prevalence; Trichomonas vaginalis; Candida albicans; antenatal careDOI: 10.3126/njog.v4i1.3325Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 11-14

Association between Thiopurines Use and Pregnancy Outcomes in Female Patients with Inflammatory Bowel Disease: A Meta-analysis

2020 ◽  
Vol 26 ◽  
Author(s):  
Yang Zhang ◽  
Dandan Li ◽  
Heng Guo ◽  
Weina Wang ◽  
Xingang Li ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Preterm Birth ◽  
Spontaneous Abortion ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy

Background: Conflicting data exist regarding the influence of thiopurines exposure on adverse pregnancy outcomes in female patients with inflammatory bowel disease (IBD). Objective: The aim of this study was to provide an up-to-date and comprehensive assessment of the safety of thiopurines in pregnant IBD women. Methods: All relevant articles reporting pregnancy outcomes in women with IBD received thiopurines during pregnancy were identified from the databases (PubMed, Embase, Cochrane Library, and ClinicalTrials.gov) with the publication data up to April 2020. Data of included studies were extracted to calculate the relative risk (RR) of multiple pregnancy outcomes: congenital malformations, low birth weight (LBW), preterm birth, small for gestational age (SGA), and spontaneous abortion. The meta-analysis was performed using the random-effects model. Results: Eight studies matched with the inclusion criteria and a total of 1201 pregnant IBD women who used thiopurines and 4189 controls comprised of women with IBD received drugs other than thiopurines during pregnancy were included. Statistical analysis results demonstrated that the risk of preterm birth was significantly increased in the thiopurine-exposed group when compared to IBD controls (RR, 1.34; 95% CI, 1.00-1.79; p=0.049; I 2 =41%), while no statistically significant difference was observed in the incidence of other adverse pregnancy outcomes. Conclusion: Thiopurines’ use in women with IBD during pregnancy is not associated with congenital malformations, LBW, SGA, or spontaneous abortion, but appears to have an association with an increased risk of preterm birth.

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